In the 1990s, the US Supreme Court observed that “Americans are engaged in an earnest and profound debate about the morality, legality, and practicality of physician-assisted suicide.”1,2 Although the court did not find a constitutionally protected liberty interest in physician-assisted suicide, it invited state experimentation.1 In 1994, Oregon legalized physician-assisted suicide when voters approved a ballot measure enacting the Oregon Death With Dignity Act.3 The Act survived a 1997 ballot initiative for repeal by a 60% margin.4 The Oregon Death With Dignity Act exempts from civil or criminal liability physicians who, in compliance with specific safeguards, dispense or prescribe (but not administer) a lethal dose of drugs upon the request of a terminally ill patient. Oregon is the only state to legally authorize physician-assisted suicide; 44 states explicitly proscribe the practice; and virtually all states make it unlawful under the general criminal law (eg, murder or manslaughter).5